| NPI | 1588050843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME145778) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C197797) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2024-08-29 |